Medical pain relief options for labour
All pain management drugs carry a risk for both you and your baby but they can be beneficial for long labours. Below are the available options.
Nitrous Oxide - Gas
Nitrous oxide or gas is mixed with oxygen and administered to you through a face mask or tube held in your mouth. It takes a few seconds to work ,so you need to breathe from the mask as soon as you feel a contraction start to build. Gas doesn't stop the pain completely, but it can help take the edge off the intensity of your contractions and act as a distraction helping you to focus on your breathing.
The downside of gas is that it can cause nausea, vomiting, confusion, and disorientation. You may also experience a claustrophobic sensation from the face mask. For some women gas does nothing to diminish labour pain.
Pethidine is a narcotic drug which is used as a temporary form of pain relief during labour. It can also help you feel relaxed to allow your cervix to open. It is administered by an intramuscular injection to your buttocks and it can last for two to four hours. You may feel nausea or it can make you feel like vomiting. It can also make you feel light headed or drowsy as it lowers blood pressure and you may develop an altered perception and feel disorientated. You may also experience respiratory depression, which can make it difficult to breathe.
Pethidine reaches your baby through the umbilical cord which may also cause respiratory depression for your baby at birth. If Pethidine is given to you late in labour 'Narcan' may need to be given to your baby at birth to reverse the effects of the pethidine.
An epidural is the most effective, continuous pain relief for during labour. An epidural anaesthesia is injected into the lining of your spinal cord through your lower back. Epidurals block the nerve impulses from your lower spinal segments, resulting in a decreased sensation in the lower half of your body. A small area in the lumbar between two vertebrates is numbed, then a tiny tube is inserted into the epidural space so that continuous anaesthetic can be administered to block the pain in your lower body.
It can take 15 to 20 minutes for an epidural to take effect. If you have had a long labour it gives you an opportunity to rest and you will be awake and alert.
If you have an epidural you may feel faint and nauseated as your blood pressure is lowered. You will no longer be active with your labour and having an epidural can slow contractions and increase the need for further intervention such as synthetic hormones to help your uterus to contact. An IV and a catheter will need to be inserted, and you and your baby will need continuous electronic fetal monitoring. You may experience side effects such as itchiness, headaches or shaking. Due to the lack of sensation in your lower body, it can also make it difficult to push and may lead to an assisted delivery with forceps or ventouse (vacuum delivery).
A spinal book anaesthetic is injected into your spinal fluid in the lower back. It is easier to administer than an epidural. It is given in a single application that takes effect within a few minutes and can last for two to three hours. The spinal block is a 'once only' procedure and is best used for a caesarean rather than for pain relief during labour as it cannot be topped up like an epidural. The effects are similar to an epidural.